Individual
MICHAEL DOUGLAS COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
109 N FRONT STREET, SANDERSVILLE, MS 39477-0001
(601) 490-7190
(601) 490-7191
Mailing address
3115 AUDUBON DR, LAUREL, MS 39440-1913
(601) 531-2200
(601) 531-2220
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R867311
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02879874
—
MS
Enumeration date
07/08/2010
Last updated
01/14/2025
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